Minimally invasive surgery is the progress of technology, but also the pursuit of medical humanization.
Traditional cardiac surgery is undoubtedly a major operation: the patient has to be “cut open” and the heart stops beating. Many children with precordial disease are cured of their heart disease, but the long scar on the chest becomes a “heart disease”. Sun Zongquan, Cardiac Surgery Department, Wuhan Union Medical College Hospital
In the province, the Department of Cardiac Surgery of the Union Hospital was the first to try a new type of minimally invasive surgical umbilical blocking procedure, in which the heart surgery is performed with a small incision in the chest.
Traditional surgery requires an open chest, and after the heart disease is cured, a long scar is left on the chest, leaving many children with a psychological disease. Now, Concordia Hospital has introduced “transthoracic atrioventricular defect umbrella plugging”, a minimally invasive surgery that can fill the “heart hole” without opening the chest.
Minimally invasive umbrella plugging is better than traditional surgery
As the name implies, minimally invasive atrioventricular blocking is a procedure to correct intracardiac malformations through a tiny incision using a blocking umbrella. The general procedure is to make a small incision in the chest, expose the local surface of the heart, insert a catheter, and through the guidance of real-time ultrasound, the catheter reaches the defect and delivers the blocking umbrella to repair the affected area, thus achieving the treatment goal.
Compared with traditional techniques, the new technique has many advantages.
First, it is less invasive and less bleeding. Minimally invasive umbrella plugging usually requires only a 2~3cm incision below the sternum, which is small and well concealed, and does not require complete chest opening, so the trauma is significantly smaller than that of traditional surgery; moreover, the operation time of minimally invasive umbrella plugging is short, the bleeding is very small, and usually no blood transfusion is needed, thus avoiding the problem of blood transfusion infection that most patients worry about.
Second, no extracorporeal circulation is required, and patients recover quickly. Although most patients can recover normally, there are still abnormal physiological reactions to varying degrees. Minimally invasive umbilical blocking does not require extracorporeal circulation and avoids harmful reactions. Moreover, patients who undergo minimally invasive umbrella plugging recover quickly and usually only need to be observed for 24 hours in the monitoring ward before they can be transferred to the general ward, while patients with intracardiac direct vision are observed for at least 48 hours.
Third, the efficacy is precise and the postoperative complications are few. Minimally invasive umbilical occlusion is done under real-time B-ultrasound guidance, which allows intraoperative observation of the surgical effect and timely adjustment; whereas the possibility of residual leakage or conduction block due to improper suturing exists in traditional surgery, which is not easily detected intraoperatively.
Rational choice of minimally invasive and interventional occlusion in surgery
Minimally invasive occlusion and interventional occlusion in cardiac surgery have their own advantages due to the different routes of surgery. Interventional occlusion is performed through the blood vessels in the legs, which is relatively less invasive and does not require general anesthesia, which is its advantage; however, it has certain requirements for age and vascular development, and because interventional surgery is performed through catheters, it requires strict requirements for the type of ventricular septal defect.
Minimally invasive occlusion, on the other hand, is intuitive because it is performed directly on the surface of the heart, without any requirements for age and blood vessels, and is also applicable to all ventricular septal defects. Since it is done under general anesthesia and in the operating room, there are many remedies and the procedure is safer, while the procedure is performed under ultrasound guidance, which not only reduces the damage of X-rays, but also has a more definite surgical efficacy. Therefore, as a patient, it is necessary to choose the sealing surgery reasonably, especially for younger patients with ventricular septal defects, or vascular developmental variants, it is recommended to choose surgical minimally invasive sealing surgery.